NPI | 1558488437 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 138808) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA C051710318) |
Enumeration Date | 2007-03-23 |
Last Update Date | 2023-11-17 |